| Regimental number | 4574 |
| Religion | Methodist |
| Occupation | Fisherman |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs Ada Phillips, Daly Street, St Kilda, Melbourne, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 21st Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/38/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Orontes on |